Could his fall have advanced his Alzheimer's?

3 answers | Last updated: Aug 30, 2016
A fellow caregiver asked...

My parents live in Sarasota; I'm way away out of state. My Dad has been exhibiting some moderate symptoms of Alzheimer's for some time. It has always been a big secret - he's in complete denial. But we can tell he's definitely been deteriorating.

Anyway, he fell a few weeks back and broke a vertebra and had surgery to repair it. He was sent home the same day to my poor mother for her to care for him. Since then, he has completely gone down hill. Not only has he become completely weak and unable to get around, but he has become extremely confused. He has exhibited some hallucinations. He also didn't know who I was on the phone the other day. The Dr. said maybe it was the pain meds and took him off on Saturday, and while he had some improvement, he walked out of the house in the middle of the night last night after putting on all the lights and setting off the alarm. He then had no explanation as to what he was doing. He also had a catheter in and must have yanked it out and was lying in urine.

My mother is elderly and has a heart condition and a bad back, and this is completely stressing her out. She can't handle him. He's a big guy. She is very small. She can't handle the stress or him.

So I am wondering a few things:

  1. Can Alzheimer's be made significantly worse quickly, after a fall?
  2. Is it made worse by pain meds and can it improve again over time without the meds?
  3. Is this common for these things to occur as a result of his fall, or is it unusual.
  4. What services are available to assist my mother in taking care of him? She needs to have assistance with transportation to Drs. and other services too. He's a Veteran and is eligible for benefits.

Expert Answers

Helene Bergman, LMSW, is a certified geriatric care manager (C-ASWCM) and owner of Elder Care Alternatives, a professional geriatric care management business in New York City. She consults with nursing homes and daycare programs to develop specialized programs for Alzheimer's patients.

Any traumatic event, like a serious fall, can worsen the symptoms of dementia but is unlikely to worsen the Alzheimer's disease itself. Of course, if your dad suffered a subdural hematoma,in addition to his fracture, then his overall functioning could worsen. I assume testing was done when he was in the ER or hospital. I am surprised that he was not sent to a subacute facility for rehabilitation rather than being sent home the same day of surgery. This sounds odd especially for an elder and someone with dementia. It sounds like your mom might not have gotten a safe and appropriate discharge plan from the Social Worker in the hospital.

Nevertheless, he is at home now and even without his pain meds which might have contributed to his behavior problems, he seems to be too difficult for your mom to manage. Have you contacted a care manager in Sarasota to help them? NPPGCM website will connect you with a local care manager there {www.napgcm.org} who could help secure home care to assist your mother with the caregiving. It sounds like he may need some psychiatric treatment to help with his psychotic symptoms and his agitated behavior. Perhaps there is a mobile crisis team that can visit immediately. The Sarasota VA might also have outreach services if he cannot travel there. Contact them at US Veterans Affairs Department"Ž 4801 Swift Road, Sarasota, (941) 927-8285"Ž. They will assign a Primary Physician who can then refer him for other medical supports. The Alzheimer Association has a Sarasota office (1230 South Tuttle Avenue Sarasota, FL 34239-2601-(941) 365-8883. They would be able to advise you and your mom of the local resources available.


Community Answers

A fellow caregiver answered...

I'm no doctor, but this sounds like it could be delirium, which can be quite serious. Dr. Leslie Kernisan, Caring.com's senior medical editor, blogged about it twice a few weeks ago here:

https://www.caring.com/blogs/older-patients-wiser-care/delirium-elderly-nonsense-delirium

https://www.caring.com/blogs/older-patients-wiser-care/understanding-hospital-delirium-in-elderly-patients


Cbs answered...

Anesthesia, Pain medications, Being in a strange place (hospital) - any one of those could have accelerated the progression of his symptoms from moderate to severe. No the "Alzheimer's " did not get worse, he just rapidly progressed further in the disease he already had. It would be unusual for any significant improvement to occur after the more severe symptoms have appeared. Likewise, it could be delirium occurring from the anesthesia or the unfamiliar place/routines of the hospital. If that is the case, improvement MIGHT occur - I hope you have already been in contact with his physician (not necessarily the surgeon) about the exacerbation of his symptoms. If not, contact him right away.